Consider first: the effects on regular people. Work requirements that go into effect in January will apply only to people in the 44 states that “expanded” Medicaid, and then only to people in the “expansion population”. That’s about 20 million people, according to KFF. Those people will need to prove they are working, going to school or volunteering at least 80 hours or earning $580 per month. People will also need to re-certify eligibility every six months, instead of every year. In short, Medicaid will be harder to get and harder to keep.